OBJECTIVE To investigate antibiotic resistance and the prevalence of serotype of Streptococcus pneumoniae in Wuhan.METHODS Totally 152 strains of S.pneumoniae were collected to test the MICs of various antibiotics by agar dilution method according to the approved standard of NCCLS.Serotyping of S.pneumoniae was performed by using quelling reaction.RESULTS Among 152 strains of S.pneumoniae,65(42.76%) strains were resistant to penicillin(MIC≥0.12mg/L).94.08%,50.66%,41.45% and 11.18% of S.pneumoniae were resistant against the first(cefalexin),second(cefaclor) and third(cefaxime and ceftriaxone) generation of cephalosporins respectively.The resistance rates to other antibiotic agents,such as erythromycin,tetracycline,trimethoprim/sulfamethoxazole and chloramphenicol,were 84.21%,88.82%,89.47% and 18.42%,respectively.Strains that were resistant to levofloxacin and moxifloxacin were found both for 1.32%.Twenty serotypes were involved in 152 strains. The prevalent serotypes were 19(25.66%),23(19.08%),6(13.82%),15(7.24%)and 14(4.61%).Eight strains were remained for unable to serotype.All penicillin-resistant S.pneumoniae was included in serotypes 6,19 and 23.CONCLUSIONS The antibiotic resistance of S.pneumoniae is serious in Wuhan.Most of them are multi-resistant strains.Except for fluoroquinolones,ceftriaxone and chloramphenicol, most antibiotic agents have lost there activities against S.pneumoniae.The prevalent serotypes,especially of the multi-resistant strains,were 19,23 and 6.Pneumococcal polyvalent vaccine can well cover these serotypes.

The distinction of antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital was investigated. Disc diffusion test was used to study the antimicrobial resistance of isolates collected from county hospitals and a teaching hospital. The data was analyzed by WHONET5 and SPSS statistic software. A total of 655 strains and 1682 strains were collected from county hospitals and a teaching hospital, respectively, in the year of 2003. The top ten pathogens were Coagulase negative staphylococci (CNS), E. coli, Klebsiella spp., S. areus, P. aeruginosa, Enterococcus spp., Enterobacter spp., otherwise Salmonella spp., Proteus spp., Shigella spp. in county hospitals and Streptococcus spp., Acinetobacter spp., X. maltophilia in the teaching hospital. The prevalence of multi-drug resistant bacteria was 5% (4/86) of methicillin-resistant S. areus (MRSA), 12% (16/133) and 15.8% (9/57) of extended-spectrum beta-lactamases producing strains of E. coli and Klebsiella spp., respectively, in county hospitals. All of the three rates were lower than that in the teaching hospital and the difference was statistically significant (P < 0. 01). However, the incidence of methicillin-resistant CNS (MRCNS) reached to 70% (109/156) in the two classes of hospitals. Generally, the antimicrobial resistant rates in the county hospitals were lower than those in the teaching hospital, except the resistant rates of ciprofloxacin, erythromycin, clindamycin, SMZco which were similar in the two classes of hospitals. There were differences between county hospitals and the teaching hospital in the distribution of clinical isolates and prevalence of antimicrobial resistance. It was the basis of rational use of antimicrobial agents to monitor antimicrobial resistance by each hospital.

Objective To investigate the treatment effect of lumbar subarachnoid continuous drainage on delayed hydrocephalus in patients with cerebral trauma after decompressive craniectomy.Methods Thirty-two patients with delayed hydrocephalus after decompressive craniectomy,admitted to our hospital from June 2009 to September 2013,were treated by lumbar subarachnoid continuous drainage;and the treatment effect was analyzed.Results After lumbar subarachnoid continuous drainage,14 patients got successful drainage tube being extracted in the first period,5 were in the second cycle;they all got avoidance ofventriculo peritoneal shunt operation.However,the other 13 patients,developed into shunt dependent hydrocephalus,were treated with ventriculoperitoneal shunt operation.No central nervous system infections were noted during the period of draining.Conclusion The treatment of lumbar subarachnoid continuous drainage,with the characteristics of small trauma and easy operating,can reduce the incidence of shunt dependent hydrocephalus,which is developed by delayed hydrocephalus.

OBJECTIVETo examine the contribution of insulin related indices on the association between body fat and blood pressure among overweight adults.

METHODSFrom April to May 2014, based on convenience sampling, we recruited overweight and obese volunteer participants aged 20-55 years living in Beijing at least 1 year through a strict examination by doctors in a physical examination center. In this study, we excluded the participants who reported suffering from any severe heart, lung, liver or kidney organic diseases, and abnormal development, disabilities, and secondary obesity caused by other disease. Also participants with use of antihypertensive drugs, hypoglycemic drugs and lipid lowering drugs were excluded for this study. A total of 1 221 participants were investigated in this study. With a simple self-designed questionnaire, the birthdates, sex, drug use, and disease history were examined. Participants' blood pressure (BP), percentage of body fat (PBF), glucose and fasting insulin level were measured. Mediation analysis was used to analyze the total effect of PBF on BP (c), the association between PBF and insulin related indices (a), and the mediation effect of serum fasting insulin level/HOMA-IR/HOMA-%S on relation between PBF and systolic/diastolic blood pressure (SBP/DBP).

RESULTSPBF was positively associated with SBP (c=0.25 ± 0.05 and 0.19 ± 0.03 for male and female, respectively, P<0.001). In males, PBF was positively associated with fasting insulin level and HOMA-IR (a=0.28 ± 0.05 and 0.24 ± 0.05, P<0.001), and negatively associated with HOMA-%S (a=-0.29 ± 0.05, P<0.001); in females, PBF was positively associated with fasting insulin level, HOMA-IR (a=0.21 ± 0.04 and 0.20 ± 0.04, P<0.001), and negatively associated with HOMA-%S (a=-0.13 ± 0.04, P<0.001). In further mediation analysis for female participants, fasting insulin level/HOMA-IR/HOMA-%S played mediation roles in the relation between PBF and SBP, with ratio of mediation of 13.78%,18.3%, and 5.98%. Fasting insulin level/HOMA-IR also mediated the relation between PBF and DBP, with mediation ratio of 11.98% and 14.13%.

CONCLUSIONIn overweight/obese female participants, insulin related indices mediated the relation between PBF and BP.

Adipose Tissue ; physiology ; Adult ; Beijing ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Female ; Humans ; Insulin ; physiology ; Insulin Resistance ; Male ; Middle Aged ; Obesity ; physiopathology ; Overweight ; physiopathology ; Risk Factors ; Young Adult

The distinction of antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital was investigated. Disc diffusion test was used to study the antimicrobial resistance of isolates collected from county hospitals and a teaching hospital. The data was analyzed by WHONET5 and SPSS statistic software. A total of 655 strains and 1682 strains were collected from county hospitals and a teaching hospital, respectively, in the year of 2003. The top ten pathogens were Coagulase negative staphylococci (CNS), E. coli, Klebsiella spp. , S. areus, P. aeruginosa, Enterococcus spp. , Enterobacter spp. , otherwise Salmonella spp. , Proteus spp. , Shigella spp. in county hospitals and Streptococcus spp. , Acinetobacter spp. , X. maltophilia in the teaching hospital. The prevalence of multi-drug resistant bacteria was 5% (4/86) of methicillin-resistant S. areus (MRSA), 12% (16/133) and 15.8 % (9/57) of extended-spectrum β-lactamases producing strains of E. coli and Klebsiella spp. , respectively, in county hospitals. All of the three rates were lower than that in the teaching hospital and the difference was statistically significant (P＜0.01). However, the incidence of methicillin-resistant CNS (MRCNS) reached to 70 % (109/156) in the two classes of hospitals. Generally, the antimicrobial resistant rates in the county hospitals were lower than those in the teaching hospital, except the resistant rates of ciprofloxacin, erythromycin, clindamycin, SMZco which were similar in the two classes of hospitals. There were differences between county hospitals and the teaching hospital in the distribution of clinical isolates and prevalence of antimicrobial resistance. It was the basis of rational use of antimicrobial agents to monitor antimicrobial resistance by each hospital.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.